4A (Expenses $ 372430776 including grants of $ 0) (Revenue $ 393495482)
PATIENT CARE (SCHEDULE O)MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA AND WISCONSIN. AS PART OF MAYO CLINIC, MAYO CLINIC HEALTH SYSTEM OFFERS OUTSTANDING CARE CLOSE TO HOME. PHYSICIANS AND STAFF IN MAYO CLINIC HEALTH SYSTEM HAVE READY ACCESS TO THE KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC, YET CAN MEET PATIENTS HEALTH CARE NEEDS LOCALLY. MAYO CLINIC HEALTH SYSTEM IS PART OF THE COMMUNITY, FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES IN WHICH WE LIVE AND WORK. MAYO CLINIC HEALTH SYSTEM TEAMS WITH MAYO CLINIC TO DELIVER UNPARALLELED HEALTH CARE TO COMMUNITIES THROUGH AN INTEGRATED NETWORK OF CLINICS AND HOSPITALS.IN 2011, MAYO CLINIC HEALTH SYSTEM SITES EMPLOYED APPROXIMATELY 900 PHYSICIANS AND 13,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT THE MAYO CLINIC HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN 72 COMMUNITIES, THE SYSTEM INCLUDES 18 OWNED HOSPITALS, SEVEN OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH TWO ADDITIONAL HOSPITALS, AND CONTRACT MANAGEMENT AGREEMENTS WITH AN ADDITIONAL HOSPITAL AND NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO CLINIC HEALTH SYSTEM HAS GROWN FROM A NEW IDEA TO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN AMERICA. MAYO CLINIC HEALTH SYSTEM COMPLETES MORE THAN TWO-MILLION PATIENT VISITS ANNUALLY. IT ALSO SERVES AS A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS BEING RECOGNIZED SIX TIMES BY THE AMERICAN MEDICAL GROUP ASSOCIATIONS ACCLAIM AWARD PROGRAM (2005 ACCLAIM AWARD RECIPIENT AND FIVE-TIME ACCLAIM AWARD HONOREE). THE ACCLAIM AWARDS HONOR PHYSICIAN-LED ORGANIZATIONS DELIVERING CARE ALIGNED WITH THE IDEAL DELIVERY MODEL WHERE PATIENTS EXPERIENCE SAFE, RELIABLE, RESPONSIVE, READILY AVAILABLE AND INTEGRATED CARE. IN ADDITION, THE MINNESOTA COUNCIL FOR QUALITY HAS RECOGNIZED MAYO CLINIC HEALTH SYSTEM THREE TIMES FOR ITS PERFORMANCE EXCELLENCE EFFORTS. INDIVIDUAL MAYO CLINIC HEALTH SYSTEM LOCATIONS HAVE ALSO BEEN HONORED FOR THEIR COMMITMENT TO QUALITY, SAFETY, SERVICE, PERFORMANCE AND THEIR COMMUNITIES.PEOPLE IN MINNESOTA, IOWA AND WISCONSIN CAN HAVE PEACE OF MIND KNOWING THAT MAYO CLINIC HEALTH SYSTEM AND MAYO CLINIC PARTNER TO ENSURE HEALTHIER LIVES IN THE REGION.MAYO CLINIC HEALTH SYSTEM FRANCISCAN MEDICAL CENTER, INC. (FMCI) FULFILLS ITS MISSION THROUGH THE FOLLOWING LOCATIONS AND SERVICES:HOSPITALS - 2 HOSPITALS, LACROSSE (248 BEDS), AND SPARTA (25 BEDS), THE ARCADIA HOSPITAL WAS CLOSED IN MARCH 2011. THE HOSPITALS PROVIDE ACUTE HEALTH CARE SERVICES INCLUDING 24-HOUR EMERGENCY CARE, ADULT AND PEDIATRIC SURGERY, LABOR, DELIVERY, MATERNITY CARE, REHABILITATION SERVICES, AND HEALTH EDUCATION CLASSES. THE HOSPITALS HAD 7,660 INPATIENT ADMISSIONS, 948 DELIVERIES, AND 8,286 SURGERIES DURING 2011.SLEEP LAB - THE FMCI SLEEP LAB HAS RECEIVED THE FULL FIVE-YEAR ACCREDITATION FROM AMERICAN ACADEMY OF SLEEP MEDICINE. THE FACILITY WAS APPROVED FOLLOWING A LENGTHY EXAMINATION PROCESS AND SITE VISIT THAT COVERED THE UNIT'S POLICIES, PROCEDURES AND ACTIVITIES. EACH YEAR THE SLEEP LAB EVALUATES APPROXIMATELY 250 PATIENTS. THE ACCREDITATION WILL OPEN UP THE LAB AS A NEW CHOICE FOR PATIENTS FROM A BROADER RANGE OF INSURANCE PLANS.NATIONAL OUTCOMES MEASUREMENT SYSTEM - SINCE JAN. 1999, THE SPEECH-LANGUAGE PATHOLOGISTS AT MCHS-FRANCISCAN MEDICAL CENTER HAVE BEEN TAKING PART IN A NATIONAL PROJECT THAT ALLOWS THEM TO TRACK PATIENT OUTCOMES AND COMPARE THEIR SERVICES WITH OTHER THERAPY PROGRAMS ACROSS THE STATE AND THE NATION. THE NATIONAL OUTCOMES MEASUREMENT SYSTEM PROJECT CONSISTS OF MAKING A SPECIAL ASSESSMENT OF THE PATIENT AT THE FIRST AND LAST VISIT. BY COMPARING SUCH FACTORS AS FUNCTIONALITY PRIOR TO CARE, NUMBER OF VISITS, NUMBER OF MINUTES OF CARE AND FUNCTIONALITY AT THE END OF THE SESSIONS, THERAPISTS CAN NOW ACCURATELY TRACK THE PROGRESS OF PATIENTS.LACROSSE COULEE REGION BRAIN TEAM - FMCI MEMBERS SERVED ON THE LACROSSE COULEE REGIONAL BRAIN TEAM, WHICH IS A COMMUNITY EFFORT TO ENCOURAGE PUBLIC DISCUSSION AND ACTIONS RELATED TO THE IMPORTANCE OF EARLY BRAIN DEVELOPMENT; TO FIND WAYS TO SUPPORT PARENTS/FAMILIES IN NURTURING THEIR CHILDREN; AND TO PROVIDE POSITIVE STIMULATING ENVIRONMENTS NECESSARY FOR LEARNING. IN COOPERATION WITH THE UNIVERSITY OF WISCONSIN-LA CROSSE, THE TEAM SURVEYED 1,200 AREA PROFESSIONALS WHO WORK WITH CHILDREN IN AN EFFORT TO DETERMINE THE LEVEL OF AWARENESS OF EARLY BRAIN DEVELOPMENT INFORMATION AND HOW THEIR PRACTICE IS AFFECTED. THE SURVEY RESULTS WILL BE USED TO DEVELOP ACTION PLANS WHICH MEET THE EDUCATIONAL NEEDS OF PROFESSIONALS WORKING WITH YOUNG CHILDREN. OTHER COULEE BRAIN TEAM EFFORTS INCLUDE ORGANIZATION OF A SPEAKERS BUREAU, MESSAGE-OF-THE-MONTH RELEASES TO MEDIA AND THE PRESENCE OF THE WISCONSIN'S BETTER BADGER BABY BUS TOUR AT RIVERFEST.CLINICS - FAMILY PRACTICE CLINICS PROVIDE OUTPATIENT SERVICES AND ARE LOCATED IN THE FOLLOWING COMMUNITIES IN WISCONSIN, IOWA, AND MINNESOTA:WISCONSIN - ARCADIA, GALESVILLE, LACROSSE, ONALASKA, PRAIRIE DU CHIEN, SPARTA, TOMAHIOWA - WAUKONMINNESOTA - CALEDONIA, LACRESCENTAFFILIATION WITH THE LARGER MAYO CLINIC HEALTH SYSTEM ALLOWS ACCESS FOR MEMBERS OF THESE COMMUNITIES TO VARIOUS SPECIALTY SERVICES. SOME OF THESE SERVICES INCLUDE:OCCUPATIONAL HEALTH - THE SERVICES INCLUDE WORKERS' COMPENSATION SERVICES, DOT PHYSICALS, JOB SITE ASSESSMENTS, HEALTH AND SAFETY CONSULTATIONS, SIGNIFICANT EXPOSURE FOLLOW-UP, DISABILITY MANAGEMENT AND RETURN-TO-WORK PROGRAMS, DRUG TESTING SERVICES, BREATH ALCOHOL TESTING AND RESPIRATOR FIT TESTING.ALLERGY - PATIENTS WITH ALLERGIC CONDITIONS AND PROBLEMS WITH IMMUNE RESPONSE ARE TREATED AND SERVICES INCLUDE BOTH CONSULTATIONS AND DIAGNOSTICS.CARDIOLOGY - CARDIOLOGY SERVICES PROVIDED INCLUDE CARDIOLOGY ASSESSMENTS, CONSULTATIONS, AND FOLLOW-UPS.GERIATRIC - SERVICES PROVIDED INCLUDE GERIATRIC CONSULTATIONS AND FOLLOW-UPS RELATED TO ALL ASPECTS OF SPECIALTY ELDER CARE INCLUDING DEMENTIA, MEMORY LOSS, MEDICATION MANAGEMENT, LONG-TERM CARE AND DISEASE MANAGEMENT.PEDIATRIC NEUROLOGY - SERVICES PROVIDED INCLUDE PEDIATRIC NEUROLOGY CONSULTATIONS AND FOLLOW-UPS. PEDIATRIC NEUROLOGY PROVIDES SUB-SPECIALTY EXPERTISE FOR CHILDREN WITH DIFFICULT SEIZURE DISORDERS, HEADACHES, DEVELOPMENTAL DISORDERS AND HYPERACTIVITY AND LEARNING DISORDERS.SKILLED NURSING FACILITIES A SKILLED NURSING FACILITY IS LOCATED IN ARCADIA, WI (75 BED CAPACITY). HOME HEALTH - HOME HEALTH SERVICES PROVIDES HEALTH CARE SERVICES TO PATIENTS IN THE CONVENIENCE OF THEIR HOME, NURSING HOME, OR HOSPITAL ROOM. THE FIVE AREAS OF CARE PROVIDED ARE HOME CARE, HOSPICE, PHARMACY, HOME MEDICAL EQUIPMENT AND INFUSION THERAPY. HOME CARE - HOME CARE INCLUDES SERVICES OF SKILLED PROFESSIONAL NURSES WHO PROVIDE SPECIALIZED CARE AND TEACHING TO PATIENTS WITH ACUTE NEEDS SUCH AS WOUNDS, OSTOMIES, DIABETES MANAGEMENT, MEDICATION MANAGEMENT, AND INFUSION THERAPY INCLUDING CHEMO ADMINISTRATION. HOME HEALTH AIDES PROVIDE PERSONAL CARE AND ASSISTANCE WITH EXERCISE PROGRAMS. PHYSICAL THERAPISTS PROVIDE SPECIALIZED CARE AND TEACHING IN THE AREAS OF HOME THERAPEUTIC EXERCISE PROGRAMS, FUNCTIONAL/ACTIVITIES OF DAILY LIVING TRAINING, GAIT TRAINING, WHEELCHAIR FITTINGS AND THE USE OF ADAPTIVE EQUIPMENT. OCCUPATIONAL THERAPISTS PROVIDE SPECIALIZED CARE AND TEACHING PATIENTS HOW TO USE ADAPTIVE EQUIPMENT FOR ACTIVITIES OF DAILY LIVING, SAFETY ADAPTATIONS, FUNCTIONAL PROGRAMS, AND ENERGY CONSERVATION WITH DAILY TASKS. HOME CARE HAD 4,277 PATIENT ENCOUNTERS IN 2011.HOSPICE - HOSPICE USES A TEAM APPROACH TO CARING FOR PATIENTS WITH LIFE THREATENING ILLNESSES, PROVIDING SPECIALIZED CARE AND TEACHING AND ALSO FOCUSES ON PATIENTS' QUALITY OF LIFE AND DEATH WITH DIGNITY. THE TEAM CONSISTS OF SKILLED NURSES, HOME HEALTH AIDS, PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, SOCIAL WORKERS, CHAPLAINS AND VOLUNTEERS. BEREAVEMENT FOLLOW-UP AFTER THE PATIENT'S DEATH IS AN ADDITIONAL BENEFIT FOR THE FAMILY. HOSPICE PROVIDES THE EQUIPMENT, MEDICATIONS AND SUPPLIES (RELATED TO THEIR LIFE THREATENING ILLNESS) NECESSARY TO ASSURE THE COMFORT OF OUR PATIENTS IN THEIR FINAL DAYS IN FAMILIAR SURROUNDINGS WITH FAMILY AND FRIENDS. HOSPICE HAD 518 PATIENT ENCOUNTERS DURING 2011.

4B (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
PATIENT CARE (SCHEDULE O) CONTINUED.PATIENT CARE (CONTINUED)HOME MEDICAL EQUIPMENT - THIS AREA OFFERS A FULL RANGE OF MEDICAL EQUIPMENT AND SUPPLIES INCLUDING BEDS, WALKERS, COMMODES, CANES, WHEELCHAIRS, SCOOTERS, SUPPLIES RELATED TO DIABETES, BREAST FEEDING, OSTOMY, AND SPORTS RELATED EQUIPMENT. RESPIRATORY THERAPISTS PROVIDE OXYGEN CONCENTRATORS AND PORTABLES, APNEA MONITORS, BI-PAPS AND CPAPS, NEBULIZERS, AS WELL AS OTHER RESPIRATORY NEEDS. OUR STAFF MEMBERS ARE TRAINED IN SEATING SYSTEMS FOR WHEELCHAIRS AND SCOOTERS. THERE ARE LOCATIONS IN LACROSSE, ARCADIA, SPARTA, AND TOMAH. FREE DELIVERY AND SERVICE IS PROVIDED IN A 100-MILE RADIUS AROUND LA CROSSE. HOME MEDICAL HAD 6,082 PATIENT ENCOUNTERS IN 2011.HOME INFUSION THERAPY - THERE WERE 172 NEW PATIENTS SERVICED BY HOME INFUSION THERAPY DURING 2011.CHARITY CARE: FMCI PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS/RESIDENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. CHARITY CARE IS ALSO PROVIDED FOR PATIENTS THAT ARE FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THE COST OF CHARITY CARE PROVIDED IN 2011 WAS APPROXIMATELY $2,316,930. THE COST OF UNCOMPENSATED CARE PROVIDED LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $24,553,784 IN 2011. THIS SHORTFALL INCLUDES THE MEDICAID SURCHARGE. ADDITIONALLY, IN 2011, FRANCISCAN MEDICAL CENTER PAID $41,810 TO MN CARE, A PROGRAM THAT OFFERS HEALTHCARE ASSISTANCE TO LOW INCOME POPULATIONS.OTHER EXPENSES REPORTED ELSEWHERE: THE UNREIMBURSED COST OF MEDICARE WAS $37,346,653 IN 2011.MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER, INC. VOLUNTARILY ENTERED INTO AN AGREEMEENT WITH THE WISCONSIN ATTORNEY GENERAL RELATING TO CHARITY CARE. THE TERMS OF THE AGREEMENT INCLUDE AN AUTOMATIC DISCOUNT FOR UNINSURED PATIENTS, A PAYMENT CAP FOR THOSE UNINSURED PATIENTS THAT MEET THE ORGANIZATION'S CHARITY CARE CRITERIA, AND A COMMITMENT TO MAKE INFORMATION AVAILABLE TO PATIENTS REGARDING OUR CHARITY CARE PROGRAM. ADDITIONALLY, THE WI ATTORNEY GENERAL REVIEWED AND APPROVED OUR BILLING AND COLLECTION POLICIES AND PRACTICES.

4C (Expenses $ 3963887 including grants of $ 34040) (Revenue $ 337480)
"COMMUNITY ACTIVITIES & EDUCATIONAL PROGRAMS (SCHEDULE O) IN ADDITION TO THESE SERVICES AND IN KEEPING WITH ITS HISTORIC MISSION, MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER, INC. ENGAGES IN NUMEROUS EXTERNAL ACTIVITIES THAT PROMOTE HEALTH AND WELLNESS FOR THE MIND, BODY AND SPIRIT OF INDIVIDUALS IN THE COMMUNITIES WE SERVE. THE MCHS-FRANCISCAN MEDICAL CENTER NOT ONLY ENGAGES IN THESE ACTIVITIES AS A SYSTEM, BUT ALSO ENCOURAGES MEDICAL STAFF AND EMPLOYEES TO DO THE SAME. EXAMPLES INCLUDE:ST. CLARE HEALTH MISSION - THE MISSION IS A FREE MEDICAL CLINIC WITH LOCATIONS ON THE MCHS-FRANCISCAN MEDICAL CENTER'S CAMPUSES IN LACROSSE AND SPARTA, AND SERVES PERSONS WHO HAVE NO MEDICAL INSURANCE AND DO NOT QUALIFY FOR PUBLIC ASSISTANCE. STAFFED BY VOLUNTEER PHYSICIANS AND OTHER EMPLOYEES, ST. CLARE HAS BECOME A MODEL FOR OTHER COMMUNITY CLINICS IN WISCONSIN. THE CLINIC HAD 4,654 PATIENT VISITS IN 2011, WITH FMCI EXPENDITURES OF $407,745 FOR THIS PROGRAM, WHICH DOES NOT INCLUDE THE VALUE OF THE MANY DONATED HOURS AND SUPPLIES. WOMEN'S HEALTH - MINNESOTA BREAST AND CERVICAL CANCER PROGRAM - THE MINNESOTA BREAST AND CERVICAL CANCER PROGRAM IS OFFERED TO PATIENTS AT THE CLINIC SITES IN MINNESOTA OR TO PATIENTS BEING SEEN IN LACROSSE FROM ONE OF THESE CLINICS FOR MAMMOGRAMS OR FOLLOW-UP BREAST OR CERVICAL CANCER PROCEDURES THAT CANNOT BE PROVIDED IN THOSE SITES. THIS PROGRAM SERVES LOW-INCOME WOMEN WHO ARE EITHER UNINSURED OR UNDERINSURED. THE GRANT WAS WRITTEN TO ADDRESS THE NEEDS OF WOMEN IN OUR RURAL MINNESOTA SITES WHO WERE NOT RECEIVING ADEQUATE PREVENTATIVE SERVICES. WISCONSIN WELL WOMAN PROGRAM - OFFERED IN COOPERATION WITH THE STATE OF WISCONSIN AND LACROSSE COUNTY, THIS PROGRAM HELPS WOMEN WITH LITTLE OR NO HEALTH INSURANCE GET BETTER ACCESS TO FREE SCREENINGS FOR BREAST CANCER, CERVICAL CANCER, DEPRESSION, DIABETES, DOMESTIC ABUSE, HEART DISEASE, HIGH BLOOD PRESSURE AND OSTEOPOROSIS. FMCI PILOTED AN EXPANDED VERSION OF THIS PROGRAM IN 2000 IN TWO DEPARTMENTS AT THE LACROSSE CAMPUS (THE CENTER FOR WOMEN'S HEALTH AND THE FAMILY HEALTH CLINIC). SAFE PATH DOMESTIC ABUSE AND SEXUAL ASSAULT SERVICE - STARTED IN 1996, THIS PROGRAM IS FUNDED THROUGH THE OPERATING BUDGET OF FMCI WITH A SIGNIFICANT GRANT FROM MCHS-FRANCISCAN HEALTHCARE FOUNDATION. IN ADDITION, IN 1999 AND 2000, THIS GROUP BEGAN WORKING WITH THE EMTC TO DEVELOP THE SEXUAL ASSAULT COMPONENT. IN 2000, 6 NURSES WERE TRAINED TO DO SEXUAL ASSAULT NURSE EXAMS IN THE EMERGENCY ROOM. THE PROGRAM PROVIDES THE VICTIM WITH ONE-ON-ONE ATTENTION OF A FEMALE NURSE PROVIDER TRAINED TO DO THE EXAM AND COLLECT THE FORENSIC EVIDENCE THAT IS NEEDED. FMCI IS NOW A ""DESIGNATED SEXUAL ASSAULT CENTER"" IN WISCONSIN. THE SEXUAL ASSAULT COMPONENT HAS BEEN FUNDED BY THE FRANCISCAN SISTERS OF PERPETUAL ADORATION (ONE OF THE CORPORATE MEMBERS OF FMCI). SOME OF THE FUNDING HAS ALSO GONE TO PROVIDE FREE COUNSELING, MONEY FOR INCIDENTAL NECESSITIES WHEN WOMEN ARE FLEEING FROM THEIR HOMES WITHOUT MONEY OR CLOTHES, MONEY FOR NEW LOCKS ON THEIR HOME, AND SIMILAR ITEMS. ESTROGEN & WOMEN'S HEALTH - THIS IS AN EDUCATIONAL PROGRAM FOR THE MEDICAL COMMUNITY ON ADVANCES IN PREVENTION, DIAGNOSIS, AND TREATMENT OF DISEASES IN WOMEN. THE TOPIC OF ESTROGEN, AND ITS ROLE IN WOMEN'S HEALTH ISSUES, CONTINUES TO BE OF GREAT IMPORTANCE. A MULTIFACETED LEARNING APPROACH WILL BE USED IN THIS COURSE, INCLUDING LECTURE FORMAT TO SHARE THE LATEST RESEARCH, SAMPLE CASE PRESENTATIONS, AND GROUP DISCUSSION. TOPICS WILL INCLUDE IDENTIFYING THOSE WOMEN WITH RISK FACTORS FOR HORMONE REPLACEMENT THERAPY AND ALTERNATIVES TO STANDARD HORMONE REPLACEMENT REGIMES INCLUDING PHYTOESTROGEN / NATURAL ESTROGENS AND HOLISTIC THERAPIES. THIS COURSE WAS DESIGNED FOR PHYSICIANS AND RESIDENTS IN FAMILY PRACTICE, INTERNAL MEDICINE AND OB/GYN, MEDICAL STUDENTS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, AND REGISTERED NURSES AND MIDWIVES. LACROSSE MEDICAL HEALTH SCIENCE CONSORTIUM - THE CONSORTIUM IS A PARTNERSHIP OF THE TWO HEALTHCARE PROVIDERS AND THREE POST SECONDARY EDUCATIONAL INSTITUTIONS IN LACROSSE. THE PURPOSE OF THE CONSORTIUM IS TO CREATE OPPORTUNITIES FOR EDUCATION AND RESEARCH IN THE ALLIED HEALTH SCIENCES. THE MOST RECENT PROJECT OF THE CONSORTIUM WAS THE OPENING OF A $27 MILLION ALLIED HEALTH EDUCATION AND RESEARCH FACILITY IN LACROSSE (HEALTH SCIENCE CENTER). FUTURE PLANS CALL FOR A NETWORK OF HEALTH EDUCATION CENTERS IN RURAL COMMUNITIES IN THE CONSORTIUM'S 27 COUNTY SERVICE AREA. JOINT COMMUNITY HEALTH INITIATIONS - FMCI OFTEN COLLABORATES WITH GUNDERSEN LUTHERAN MEDICAL CENTER, COUNTY HEALTH DEPARTMENTS AND OTHER ORGANIZATIONS INTERESTED IN COMMUNITY HEALTH AND WELL-BEING ON NUMEROUS TOPICS, SUCH AS EDUCATION CONFERENCES, CHILD DEVELOPMENT MATERIALS, INFLUENZA VACCINATION EDUCATION ANNOUNCEMENTS, CHILD SAFETY, MEDICATION SAFETY, AND COMMUNITY HEALTH ASSESSMENT PROGRAMS.ADVANCE DIRECTIVES PROGRAM - ESTABLISHED IN COOPERATION WITH GUNDERSEN LUTHERAN, THE PROGRAM ASSISTS PATIENTS AND THEIR FAMILIES WITH END-OF-LIFE ISSUES AND DECISION- MAKING. THE PROGRAM WAS RECENTLY CITED AS ONE OF SIX MODEL PROGRAMS IN THE NATION.FREE HEALTH CHECKS AND SCREENINGS - PHYSICIANS, HEALTH EDUCATORS, AND OTHER ALLIED HEALTH STAFF PROVIDE NUMEROUS HEALTH SCREENINGS AT EVENTS THROUGHOUT THE MCHS-FRANCISCAN HEALTHCARE (FHI) SERVICE AREA. SUCH SCREENINGS INCLUDE BLOOD PRESSURE, CHOLESTEROL, BLOOD SUGAR, AND STROKE ASSESSMENTS.HEALTH AND WELLNESS EDUCATION FOR THE PUBLIC - PROGRAMS OFFERED THROUGH FMCI INCLUDE PRENATAL CARE, SMOKING CESSATION, SUPPORT GROUPS FOR CANCER, SUDDEN INFANT DEATH, NEUROLOGICAL DISORDERS, DIABETES EDUCATION, AND BASIC AND ADVANCED LIFE SUPPORT INSTRUCTION OR CPR.LACROSSE-MAYO FAMILY PRACTICE RESIDENCY - THE FAMILY PRACTICE RESIDENCY PROGRAM IS AFFILIATED WITH THE MAYO GRADUATE SCHOOL OF MEDICINE. ITS FOCUS IS TO GIVE RESIDENTS THE KNOWLEDGE, SKILLS, AND ATTITUDES NECESSARY FOR FUTURE PRACTICE IN AN EVER-CHANGING MEDICAL ENVIRONMENT. FMCI EXPENDITURES FOR THIS PROGRAM IN 2011 WERE $2,448,437. CLINICAL PASTORAL EDUCATION PROGRAM - REESTABLISHED IN 1999, THIS PROGRAM IS WORKING COLLABORATIVELY AND ECUMENICALLY TO PROVIDE PASTORAL EDUCATION FOR CLERGY AND LAY PEOPLE OF ALL FAITH TRADITIONS AND DENOMINATIONS. THE PROGRAM'S PROFESSIONAL CONSULTATION BOARD IS COMPRISED OF REPRESENTATIVES FROM A DIVERSITY OF FAITH AND COMMUNITY ORGANIZATIONS. THE PROGRAM IS COMMUNITY-BASED AND IS DESIGNED TO PROVIDE MINISTRY TRAINING IN NON-TRADITIONAL SETTINGS WHERE SPIRITUAL CARE MAY NOT CURRENTLY EXIST. AN EMPHASIS IS PLACED ON PROVIDING SPIRITUAL CARE IN AN INTER-DISCIPLINARY ENVIRONMENT THAT SERVES PEOPLE TRADITIONALLY PUSHED TO THE MARGINS OF THE COMMUNITY BY POVERTY, MENTAL ILLNESS, RACISM, VIOLENCE, OR OTHER SOCIOECONOMIC CONDITIONS.GERONTOLOGY CERTIFICATE PROGRAM - IN A JOINT EFFORT WITH THE UNIVERSITY OF WISCONSIN-LACROSSE AND COMMUNITY AGENCIES, THIS NEW PROGRAM IS DESIGNED TO INCREASE THE SKILLS AND COMPETENCIES OF A BROAD RANGE OF PROFESSIONALS INCLUDING NURSES, NURSING ASSISTANTS, SOCIAL WORKERS, OCCUPATIONAL THERAPISTS, PHYSICAL THERAPISTS, PERSONAL CARE ASSISTANTS AND OTHERS. IT IS A DIRECT RESPONSE TO THE GROWING DEMAND PLACED ON AREA AGENCIES TO SERVE OUR RAPIDLY EXPANDING POPULATION OF OLDER ADULTS. THIS PROGRAM REQUIRES CORE WORKSHOPS, ELECTIVE WORKSHOPS, AND A WORK PRACTICUM.CORPORATE FINANCIAL SUPPORT - IN BEING A ""GOOD CORPORATE CITIZEN"", FMCI ALSO PROVIDES FINANCIAL SUPPORT TO GROUPS WITHIN OUR SERVICE AREA WHO ARE ENGAGED IN COMMUNITY HEALTH AND WELLNESS, PUBLIC SAFETY, THE ARTS, EDUCATION AND QUALITY OF LIFE ISSUES. THESE ACTIVITIES INCLUDE: RUNS AND WALKS TO RAISE FUNDS FOR MEDICAL RESEARCH, PROGRAMS ON SELF ESTEEM FOR YOUNG WOMEN, FIRE SAFETY MATERIALS FOR SCHOOL CHILDREN, RECOGNITION FOR THE CONTRIBUTIONS OF OUR VOLUNTEER TEAM, SELF-HELP OPPORTUNITIES FOR THE POOR AND UNDERPRIVILEGED, CONCERTS AND PERFORMANCES BY LOCAL FINE ARTS GROUPS, AND SPONSORSHIPS OF LECTURES AND PROGRAMS ON HEALTH RELATED TOPICS.ALZHEIMER'S ASSOCIATION - FOR SEVERAL YEARS FMCI HAS BEEN A SPONSOR OF MEMORY WALKS HELD EACH FALL AND ITS ANNUAL EDUCATION CONFERENCE. SEVERAL MAYO CLINIC PHYSICIANS HAVE PRESENTED AT THE ANNUAL CONFERENCE.AMERICAN CANCER SOCIETY - FRANCISCAN MEDICAL CENTER WAS THE LEAD SPONSOR OF THE VERY FIRST LACROSSE AREA ALL YOUTH RELAY FOR LIFE. THIS RELAY, MODELED AFTER THE SUMMER EVENT, AND ORGANIZED AND DESIGNED ESPECIALLY FOR HIGH SCHOOL STUDENTS, RAISED MORE THAN $20,000. THE DAFFODILS THAT DECORATE THE MARKET PLACE RESTAURANT EACH SPRING ARE ALSO PART OF FMCI'S SUPPORT.AMERICAN HEART ASSOCIATION - STAFF FROM FMCI CARDIOVASCULAR SERVICES PLAY A LEAD ROLE IN THE ORGANIZATION OF THE ANNUAL HEART WALK. FOR THE PAST SEVERAL YEARS TEAMS FROM THE MEDICAL CENTER HAVE ALSO LED THE PACK IN FUNDS RAISED. THE MEDICAL CENTER IS ALSO A LONGTIME SPONSOR OF THE FRIGID FIVE RUN HELD IN JANUARY."

4D (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
"COMMUNITY ACTIVITIES & EDUCATIONAL PROGRAMS CONTINUED (SCHEDULE O): UNITED CEREBRAL PALSY - FRANCISCAN MEDICAL CENTER HAS BEEN THE LEAD SPONSOR FOR THE ANNUAL CELEBRITY WAITER NIGHT SINCE THIS EVENT FIRST CAME TO LACROSSE SIX YEARS AGO.MULTIPLE SCLEROSIS - FMCI WAS THE LEAD SPONSOR FOR THIS EVENT, HELD IN APRIL, THAT HAS RAISED NEARLY $80,000 YEARLY THROUGH THE EFFORTS OF MORE THAN 800 WALKERS.UNITED FUND FOR THE ARTS AND HUMANITIES - UFAH IS A CONSORTIUM OF 10 LOCAL ARTS AND HUMANITIES ORGANIZATIONS THAT CONTRIBUTE SIGNIFICANTLY TO THE QUALITY OF LIFE IN THE AREA. FMCI IS ONE OF ONLY FOUR LOCAL BUSINESSES THAT HAS BEEN A CONTRIBUTOR TO THIS ANNUAL CAMPAIGN.HEALTH CAREER EXPLORATION - YOUNG MEN AND WOMEN INTERESTED IN HEALTH CAREERS HAVE AN OPPORTUNITY TO JOB SHADOW OR INTERN IN NUMEROUS PATIENT CARE AREAS WITHIN FMCI AND FHI. MANAGED BY THE VOLUNTEER SERVICES AREA, UPPER-CLASS HIGH SCHOOL STUDENTS MAY SPEND A DAY TO SEVERAL WEEKS GATHERING FIRST HAND EXPERIENCE WITH HEALTHCARE OPPORTUNITIES. REPRESENTATION ON COMMUNITY BOARDS - FHI PROVIDES SUPPORT FOR PHYSICIANS AND EMPLOYEES WHO PARTICIPATE AT THE ""BOARD OF DIRECTOR"" LEVELS IN COMMUNITY SERVICE ORGANIZATIONS. ALL ARE ENCOURAGED TO IDENTIFY OPPORTUNITIES WHEREBY FHI CAN CONTRIBUTE ITS COLLECTIVE KNOWLEDGE AND EXPERTISE IN ASSISTING THESE COMMUNITY GROUPS TO MEET THEIR MISSIONS OF SERVICE.HEALTHTOUCH - WITH A TOUCH OF THE SCREEN, PATIENTS AND STAFF CAN NOW ACCESS ACCURATE, UP-TO-DATE INFORMATION ON MEDICATIONS, DISEASES AND WELLNESS TOPICS THANKS TO HEALTHTOUCH, AN INTERACTIVE KIOSK INSTALLED IN 2000 IN THE RESOURCE LIBRARY OF THE FAMILY HEALTH CLINIC. THE DATA CAN BE READ ON SCREEN OR PRINTED FOR LATER REVIEW. SOME TOPICS EVEN OFFER BRIEF VIDEO CLIPS. HEALTHTOUCH OFFERS INFORMATION FROM SUCH TRUSTED SOURCES AS THE AMERICAN HEART ASSOCIATION, THE ARTHRITIS FOUNDATION AND THE CENTERS FOR DISEASE CONTROL. HEALTHTOUCH SERVICE IS PROVIDED FREE FOR PATIENTS, STAFF AND THE GENERAL PUBLIC THROUGH A GRANT FROM THE MCHS-FRANCISCAN HEALTHCARE FOUNDATION.DISEASE MANAGEMENT STRATEGIES - FMCI IS PARTICIPATING IN THE UNITED COULEE REGION INFLUENZA COALITION IN COOPERATION WITH GUNDERSEN LUTHERAN AND THE HEALTH DEPARTMENT IN AN EFFORT TO COLLABORATE ON IMPROVING THE IMMUNIZATION RATES IN THE COMMUNITY. DISEASE MANAGEMENT STRATEGIES TRANSLATES RESEARCH INTO PRACTICE BY INCORPORATING INTO PATIENT CARE THE ""BEST PRACTICES"" SUPPORTED BY LITERATURE THROUGH THE USE OF CONTINUOUS IMPROVEMENT TECHNIQUES. IN THIS PROCESS, FMCI STRIVES TO IMPROVE SERVICE, CLINICAL OUTCOMES, AND COST, WHICH ARE THREE FACTORS PATIENTS ASSOCIATE WITH QUALITY. DEMENTIA CARE - FMCI HAS DEVELOPED A COMPREHENSIVE DEMENTIA CARE PROGRAM FOR PEOPLE WITH DEMENTIA AND THEIR FAMILIES. THE PROGRAM PROVIDES DIAGNOSIS, TREATMENT, EDUCATION, SUPPORT SERVICES AND LONG-TERM FOLLOW-UP. IT RELIES ON THE COLLABORATIVE EFFORTS OF PRIMARY CARE PHYSICIANS, GERIATRIC, BEHAVIORAL HEALTH, AND NEUROLOGY PROFESSIONALS FOR A COMPLETE PLAN OF CARE. THE PROGRAM IS ALSO PART OF THE WISCONSIN ALZHEIMER'S INSTITUTE AT THE UNIVERSITY OF WISCONSIN-MADISON AND ITS STATEWIDE NETWORK OF DIAGNOSTIC AND REFERRAL CENTERS. COLLEAGUES AT MAYO CLINIC ALZHEIMER'S DISEASE RESEARCH CENTER, WHO ARE IN THE FOREFRONT OF CLINICAL RESEARCH AND STUDIES, ARE AVAILABLE FOR CONSULTATIONS AT ANY TIME, THUS ENABLING FMCI PATIENTS TO BE ON THE CUTTING EDGE OF COMMUNITY-BASED CARE, TREATMENT AND RESEARCH.VOLUNTEER ACTIVITIES: MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER, INC. (VIA THE FRANCISCAN AUXILIARY WHICH IS PART OF FMCI) RECEIVES DONATED SERVICES FROM COMMUNITY TEEN, COLLEGE, AND ADULT VOLUNTEERS. THE AUXILIARY WAS ORGANIZED IN 1952 TO ""IMPROVE THE HEALTH OF INDIVIDUALS AND COMMUNITIES"" THROUGH FUNDRAISING, SERVICE, COLLABORATION, ADVOCACY AND EDUCATION. AUXILIARY PROJECTS ARE ORGANIZED BY A BOARD OF DIRECTORS THAT MEETS MONTHLY DURING THE SCHOOL YEAR AND ARE SUPPORTED THROUGH THE VOLUNTEER EFFORTS OF MORE THAN 200 MEMBERS. MEMBERSHIP IS OPEN TO ALL INTERESTED COMMUNITY MEMBERS. SPECIFICALLY, THE AUXILIARY SUPPORTS PROGRAMS AND SERVICES TO ADDRESS UNMET HEALTHCARE NEEDS; EQUIPMENT AND SERVICES TO ENHANCE PATIENT CARE DELIVERY; NEEDY PATIENT ACCOUNTS; NURSING EDUCATION FOR WWTC AND VITERBO COLLEGE STUDENTS; AND COMMUNITY HEALTH AWARENESS AND EDUCATION PROJECTS. THE AUXILIARY ALSO STRIVES TO ENHANCE THE VISIBILITY OF FMCI IN THE COMMUNITY.DURING 2011, THESE VOLUNTEERS DONATED APPROXIMATELY 61,000 HOURS OF VOLUNTEER SERVICE THESE SERVICES WERE VALUED AT APPROXIMATELY $1,329,190 BASED ON THE INDEPENDENT SECTOR, A DIVISION OF THE POINTS OF LIGHT FOUNDATION, AVERAGE ESTIMATED HOURLY VALUE OF SUCH SERVICES. THESE SERVICE HOURS WERE SPENT ORGANIZING AND MANAGING ACTIVITIES FOR THE BENEFIT OF THE HOSPITAL'S AND NURSING HOME'S PATIENTS, PATIENTS' FAMILIES, VISITORS AND STAFF."

Part I, Line 6a: THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO CLINIC.

Part I, Line 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO.

Part I, Line 7g: THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $203,485.

Part II: THE FILING ORGANIZATION MADE SEVERAL CONTRIBUTIONS TO CHARITABLE ORGANIZATIONS WITHIN THE COMMUNITY WHICH PROMOTED EDUCATION, ATHLETICS AND SAFETY. SOME EXAMPLES WOULD BE TO VARIOUS HIGH SCHOOLS, A SOFTBALL COMPLEX AND NATIONAL CHILD SAFETY COUNCIL.

Part III, Line 4: THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.FOOTNOTE FROM MAYO CLINIC 2011 CONSOLIDATED AUDITED FINANCIAL STATEMENTS: ACCOUNTS RECEIVABLE FOR MEDICAL SERVICES ACCOUNTS RECEIVABLE FOR MEDICAL SERVICES ARE STATED AT NET REALIZABLE VALUE. THE CLINIC ESTIMATES THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORIC WRITE-OFFS AND THE AGING OF THE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN COLLECTION EFFORTS HAVE BEEN EXHAUSTED.METHODOLOGY FOR SCHEDULE H, PART III, LINE 2:BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.

Part III, Line 8: THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY ACTUALLY RESULTS IN A MEDICARE SHORTFALL OF $37,346,653 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.

Part III, Line 9b: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING EVERY REASONABLE ATTEMPT TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILTY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT.

FRANCISCAN MEDICAL CTR-LACROSSE HOSPITAL
Part V, Section B, Line 11h: FAMILY SIZE

FRANCISCAN MEDICAL CTR-SPARTA HOSPITAL
Part V, Section B, Line 11h: FAMILY SIZE

FRANCISCAN MEDICAL CTR-ARCADIA HOSPITAL
Part V, Section B, Line 11h: FAMILY SIZE

FRANCISCAN MEDICAL CTR-LACROSSE HOSPITAL
Part V, Section B, Line 13g: WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.

FRANCISCAN MEDICAL CTR-SPARTA HOSPITAL
Part V, Section B, Line 13g: WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.

FRANCISCAN MEDICAL CTR-ARCADIA HOSPITAL
Part V, Section B, Line 13g: WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.

FRANCISCAN MEDICAL CTR-LACROSSE HOSPITAL
Part V, Section B, Line 19d: IN ACCORDANCE WITH AN AGREEMENT WITH THE STATE OF WISCONSIN ATTORNEY GENERAL'S 8% DISCOUNT THE POLICY RESULTS IN AN AMOUNT LESS THAN USING THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE.

FRANCISCAN MEDICAL CTR-SPARTA HOSPITAL
Part V, Section B, Line 19d: IN ACCORDANCE WITH AN AGREEMENT WITH THE STATE OF WISCONSIN ATTORNEY GENERAL'S 8% DISCOUNT THE POLICY RESULTS IN AN AMOUNT LESS THAN USING THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE.

FRANCISCAN MEDICAL CTR-ARCADIA HOSPITAL
Part V, Section B, Line 19d: IN ACCORDANCE WITH AN AGREEMENT WITH THE STATE OF WISCONSIN ATTORNEY GENERAL'S 8% DISCOUNT THE POLICY RESULTS IN AN AMOUNT LESS THAN USING THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE.

Part VI, Line 2: MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER COLLABORATES WITH PUBLIC AND PRIVATE GROUPS IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. THESE GROUPS AND DATA SOURCES INCLUDE: 2012 COMMUNITY NEEDS ASSESSMENT IN PARTNERSHIP WITH THE GREAT RIVERS UNITED WAY AND GUNDERSON LUTHERAN MEDICAL CENTER;HEALTHIEST WISCONSIN 2020 (PLAN OF WI DHS); POPULATION HEALTH PROJECT OF THE LACROSSE MEDICAL HEALTH SCIENCE CONSORTIUM, WHICH COLLECTS AND ANALYZES DATA FROM A 20 COUNTY AREA THAT MIRRORS THE REPORTING ORGANIZATION'S SERVICE AREA. MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER ALSO HAS REPRESENTATION ON NUMEROUS LOCAL HEALTH ADVOCAY GROUPS THAT TARGET SPECIFIC DISEASES AND CONDITIONS (CHILDHOOD OBESITY, DIABETES, SMOKING CESSATION, SUICIDE PREVENTION, ETC.). WE USE INFORMATION AND DATA FROM THESE GROUPS AS WELL TO HELP PLAN EVENTS IN THE SERVICE AREA.

Part VI, Line 3: MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY:MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WILL WIDELY PUBLICIZE THIS POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES WILL MAKE A COPY OF THIS POLICY AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST. THE POLICY EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.

Part VI, Line 4: MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER, INC. IS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT SERVES THE RESIDENTS OF BUFFALO, TREMPELEAU, JACKSON, MONROE, LACROSSE, JUNEAU, VERNON, CRAWFORD, RICHLAND, SAUK, AND GRANT COUNTIES IN WISCONSIN, WABASHA, WINONA, FILLMORE, AND HOUSTON IN MINNESOTA, AND WINNESHIEK, AND ALLAMAKEE IN IOWA. THE CITIES OF LACROSSE (50K) AND WINONA (35K) REPRESENT SMALL METROPOLITAN AREAS AND THE BALANCE OF THE SERVICE AREA IS EITHER RURAL OR SMALL TOWNS (500 TO 10K). THE SERVICE AREA INCLUDES A GROWING NUMBER OF HISPANIC AND HMONG RESIDENTS. THE AREA POPULATION ALSO TRENDS OLDER, POORER AND LESS EDUCATED THAN THE STATEWIDE AVERAGE.

"Part VI, Line 5: THIS FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF ""THE NEEDS OF THE PATIENT COME FIRST."" THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION- EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATIONS ACTIVITIES.SURPLUS FUNDS:MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. COMMUNITY REPRESENTATION ON GOVERNING BODY:THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINICS NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, EXPERIENCE, AND OTHER CRITERIA ESTABLISHED BY THE INDEPENDENT NOMINATING COMMITTEE OF THE BOARD OF TRUSTEES. AREAS OF EXPERTISE AND EXPERIENCE INCLUDE SUCH AREAS AS HEALTH CARE POLICY, RESEARCH, EDUCATION, BUSINESS, AND GOVERNMENT. THE FILING ORGANIZATION, WHICH IS CONTROLLED BY MAYO CLINIC, RELIES ON THE COMMUNITY REPRESENTATION OF THE MAYO CLINIC BOARD OF TRUSTEES TO FULFILL THIS REQUIREMENT.OPEN V. CLOSED STAFF MODEL:STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. EMERGENCY ROOM:THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY."

Part VI, Line 6: MAYO CLINIC HEALTH SYSTEM:THIS ORGANIZATION IS A PART OF MAYO CLINIC HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO CLINIC HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.FOR A MORE SPECIFIC DESCRIPTION, SEE THE RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O).

PART VI, LINE 7
NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED ON THE MINNESOTA HOSPITAL ANNUAL REPORT OR TO THE WISCONSIN HOSPITAL ASSOCIATION.